Epidemiologic consequences of moderate coverage levels of measles vaccine in a district headquarter town (Alwar) in India, 1996

This paper describes the epidemiology of measles in a medium size town (pop ulation 240 000) in India where vaccine coverage levels have remained const ant at around 70 per cent in the past 7 years, A retrospective community su rvey covering 4023 children under 10 years old detected 252 cases of measle s in the previous year. This gave an annual incidence of 6.3 per cent (95 p er cent CI 5.5-7). About half of the cases occurred in vaccinated children. Only 5 per cent of the cases occurred in children below 9 months of age. T his age is appropriate for routine measles immunization. Despite modest cov erage levels with only 54 per cent effective vaccine (estimated by a screen ing method), there was a modest upward shift in the age distribution of mea sles cases; the median age was more than 48 months.